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PM or PCP responsibility?

AnonymousUserAAnonymousUser Posts: 49,671
edited 06/11/2012 - 8:19 AM in Pain Medications
I am so glad I have found you guys! It is so nice to have someone(s) who actually know how I feel..now, my situation is this...my PCP has been treating me for herniated discs, stenosis, and sciatica for 3 yrs..when it became apparent this was going to be a chronic problem, she sent me to PM...(after ortho, chiro, accupuncture, massage, PT) the last time she gave me a script,( I take 500mg hydrocodone 3x a day), she said it was for the month to get me through to my PM appt...Pm has scheduled an ESI for three weeks from now...PM gave me Celebrex ($$$)which does even less than Ibruprofen, when I said my PCP told me to get the hydro from them, PM told me they are going to "hold off" on writing anything, and they would send a letter to my PCP asking her to continue to write the script..and they said to call PCP and ask for enough meds to get me to my procedure...my question is..who is responsible for this? I don't want to alienate either one by "beggigng" HELP!


  • My primary doctor,always prescribes my pain meds,my pain management doctor only gaveme injections....
  • That is really strange. When my issues first began my PCP gave me enough meds to last until PM appointment, then PM took over. I am wondering if your PM has temporarily lost their DEA or controlled subtance writing authorization; don't assume its because they're a bad doctor, may just be a matter or someone in the office didn't file/pay their license renewal,or there is a investigation (as you know often unjustified - thank God for the PM's that treat pain seriously). Permission to write can be suspended temporarily for something as simple as forgetting to document an after hours call in of an Rx into a chart. You might want to check with you State Medical Board and see if there is something going on.
  • I have been seeing my PCP for probably 7 months for this back issue. Once in a while he would write me a script for vocodin, but rarely. Mostly he would send me home with a diagnosis of muscle spasms, and a script for an anti-inflammatory, and maybe a muscle relaxer.

    After 6 months of constant "muscle spasm" diagnoses, I demanded an MRI... which finally proved that my problem was much worse than "spasms" My PCP told me to consult a neurosurgeon (appt sched next month) and a neurologist. The neurologist (who doesn't think I need surgery) is currently prescribing my pain meds.

    I was ~not so gently~ informed last week by my PCP that he was no longer willing to do that. I wasn't even seeing him that day for pain meds... we were discussing smoking cessation options, which led to a very hurtful and insulting rant about narcotic pain relievers, my need for surgery, and how I should be consulting a PM. I don't know where to find a PM... and was too frustrated and upset to think to ask my PCP to refer me to one.

    I have been spending a lot of time on this site since my MRI, and what I understand by reading the posts here, most PCP's don't prescribe pain meds, for any long term use anyway. I don't have any experience with PM (yet) but from what I have read, and what my PCP told me, they should be in charge of medication.

    In my opinion, If the meds that your PM are prescribing, aren't doing the job, you have the right to ask for something else, or something more. I understand the feelings that go along with "asking" or "complaining" but you need to stand up for yourself... Now if I could only listen to my own advice! :)

  • Hi, Amanda~
    Hard to believe your PCP did that to you after seeing your MRI! That really burns me up, that a doctor not ONLY won't Rx meds for your back pain, which has now been shown to be "legit" on your MRI, but that he has the nerve to LECTURE you about the use of these meds!
    I have been on meds for 20+ years, all Rx'd by my wonderful, compassionate yet careful PCP, who I feel is my "partner" in dealing w/my pain issues while still trying to work and have a life! I've been his patient since 1980, and he has never once tried to "make me feel guilty" or weird about having to take Percocet (since then, I've switched to oxycontin Ext. Release w/no tylenol since he was concerned about possible liver damage from that).
    I have had no bad side effects besides the usual constipation, which I take measures to correct, and this medication has allowed me to have a job and raise a family which is all I could ask for, as a person w/chronic back pain. I don't know what I would have done without him helping me, as the constant pain made me so depressed, I wanted to give up many times, until we found the right meds, and the right dose to make life "liveable".
    I learned not to mention my meds in front of people, as some people act like you just said "yeah, I smoke CRACK!" when you tell them you take meds for pain! I can't believe the ignorance and judgmental attitude some people have, so I've learned not to say anything about my issues, and it really is none of anyone's business.
    I just get upset when I see people that legitimately need to take some sort of meds for pain denied them, for some sort of prejudice, by their own DOCTOR! I think that is cruel and ignorant.
    Well, anyway, that is my 2cents on the subject, and I just wanted to say my own PCP is the one who Rx's all my meds, of any kind.
    Good luck to you and I hope you find your answer, whether it is surgery if needed, or just finding the "tools" to live a good life, even with chronic pain. I wish people would not be so judgmental until they have walked a mile in our shoes!
  • My neuro sent to me to a PM Dr. who put me on my meds to start, but when I decided against the ESI's he would no longer handle my meds and sent me, along with a letter stating this, back to my PCP to take of my meds. My PCP was alittle upset by this because he told me the PM Dr. knows more about the pain meds and controlling chronic pain. At least I have a great PCP and he is working with me and helping anyway he can. It seems like all the PM wanted to do was give the shots and nothing else. He even told me he didn't think the shots would work for me so that is why I decided against them.
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